• Shashank Raj

Mucormycosis or Black Fungus ?

During these days when the situation in India is almost tiring due to the Covid-19 pandemic, people here in India have also started reporting auxiliary disease infection known as Mucormycosis or Black Fungus during or after recovering from Covid-19 disease.


As observed and and reported by various Blog readers there is isn't much data available with local media so they requested me to make a compilation blog covering relevant details about this disease.

Representative Image of Mucormycosis
Under Microscope (Image Courtesy: Shutterstock)

So above two images are just for illustration purpose nothing else. Now moving towards the main agenda of the day,


What it is ?

In simple Mucormycosis is a fungal infection that mainly affects people who are on medication for other health problems that reduces their ability to fight environmental pathogens.

The above definition is most suitable for Disseminated Mucormycosis (given this because it is most prevalent in India).


How it occurs ?

As any other fungal disease this is also called group of molds called mucormycetes which are readily present throughout the environment.

Remember that maintaining hygiene is the most important step towards eliminating any possibility that gives rise to this infection.


What are the common symptoms ?

Symptoms of rhinocerebral (sinus and brain) mucormycosis include:

  • One-sided facial swelling

  • Headache

  • Nasal or sinus congestion

  • Black lesions on nasal bridge or upper inside of mouth that quickly become more severe

  • Fever

Symptoms of pulmonary (lung) mucormycosis include:

  • Fever

  • Cough

  • Chest pain

  • Shortness of breath

Cutaneous (skin) mucormycosis can look like blisters or ulcers, and the infected area may turn black. Other symptoms include pain, warmth, excessive redness, or swelling around a wound.

Symptoms of gastrointestinal mucormycosis include:

  • Abdominal pain

  • Nausea and vomiting

  • Gastrointestinal bleeding

Disseminated mucormycosis typically occurs in people who are already sick from other medical conditions, so it can be difficult to know which symptoms are related to mucormycosis. Patients with disseminated infection in the brain can develop mental status changes or coma.


Source: CDC ( Centers for Disease Control and Prevention)


How it is Diagnosed ?

Generally diagnosed in combination with Physical Examination and Laboratory Tests that might include combination of CT Scans of lungs, fluid samples etc.


How it is treated ?

Mucormycosis is a serious infection and needs to be treated with prescription antifungal medicine, usually amphotericin B, posaconazole, or isavuconazole. These medicines are given through a vein (amphotericin B, posaconazole, isavuconazole) or by mouth (posaconazole, isavuconazole). Other medicines, including fluconazole, voriconazole, and echinocandins, do not work against fungi that cause mucormycosis. Often, mucormycosis requires surgery to cut away the infected tissue.


Source: CDC ( Centers for Disease Control and Prevention)


Disclaimer: Individual person might require personalized treatment which is combination with other treatments which are required to be taken in consultation with a health professional. The author is not responsible and has not made any claims regarding the treatment available and strongly suggests that people should consult health professional before reaching any conclusion.


Prevention ?

First and foremost it is non contagious means it is non-communicable. So just relax and follow the said steps to prevent it:

  • Use masks if you are visiting dusty construction sites.

  • Wear shoes, long trousers, long sleeve shirts and gloves while handling soil (gardening), moss or manure.

  • Maintain personal hygiene, including thorough scrub bath.

  • The disease can be managed by controlling diabetes, discontinuing immunomodulating .drugs, reducing steroids and extensive surgical debridement- to remove all necrotic materials, according to the advisory.

DOs

  • Control hyperglycemia

  • Monitor blood glucose level post-COVID-19 discharge and also in diabetics

  • Use steroid judiciously – correct timing, correct dose and duration

  • Use clean, sterile water for humidifiers during oxygen therapy

  • Use antibiotics/antifungals judiciously

Don'ts

  • Do not miss warning signs and symptoms

  • Do not consider all the cases with blocked nose as cases of bacterial sinusitis, particularly in the context of immunosuppression and/or COVID-19 patients on immunomodulators

  • Do not hesitate to seek aggressive investigations, as appropriate (KOH staining & microscopy, culture, MALDITOF), for detecting fungal etiology

  • Do not lose crucial time to initiate treatment for mucormycosis

Above information under prevention section is based on the information made available by ICMR (Indian Council of Medical Research)


See the tweet below,


So that is all for today and I guess this blog covers all the major aspect of this disease. Remember it is not new but more prevalent these days as people are facing low immunity after recovering from the Covid-19 infection and India there are many people here in India who have reportedly lost their eyesight after getting this infection and ultimately death but remember my dear friends nothing is permanent in this world and together we will overcome this situation soon and again if you have anything in your mind that you think to share with me just drop it in the box below and I would be more than happy to get back to you at the earliest.

Till then Bye...😉


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